Q. Awhile ago I began a cycle of 50mg of Clomid (Clomiphene citrate). I got pregnant and then miscarried at five weeks. I waited three months before taking Clomid again. Second cycle, 50mg Clomid, ovulation days 16-18, follicles 22 & 24mm and other little ones. My period is now four days late and I had a negative pregnancy test. When should I expect a period? I ovulated, had follicles, great uterine lining, but still nothing. Shouldn't I get a period or be pregnant?
A. The side effects of Clomid can include mood swings, hot flashes, breast tenderness, "hostile" cervical mucous and thinning of the uterine lining. Ironically, Clomid can cause hostile cervical mucous and thin the uterine lining in over 30 percent of the women who use it. The hostile mucous kills sperm, and a thin uterine lining can prevent implantation or cause an early miscarriage, which may have been the case with your previous pregnancy.
If your doctor is carefully monitoring your follicular development, uterine lining, progesterone levels and all looks good but pregnancy fails, you may have hostile cervical mucous. This can be determined by a PCT test (post coital) performed during ovulation. If hostile mucous prevents the sperm from traveling through the cervix, then an IUI (intra-uterine insemination) can be done to induce pregnancy. This may be your best bet if this cycle doesn't produce a pregnancy.
Since you ovulated 16 to 18 days later instead of the standard 12 to 14, your menstrual cycle may be off a little, too. If you don't get your period after another week, try another HPT or visit your OB/GYN to check for pregnancy.
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Q. I have been on Clomid for two months now, with this being my second month. I am now three days late for my cycle. I had a pregnancy test done yesterday and it was negative. My HCG level has always been a little lower than normal, so I am wondering how much longer I should wait until I do a HPT? Should I just request a blood test?
A. Since your HCG levels have been low in the past, a blood test may be the best way for you to determine pregnancy. The urine home pregnancy tests sometimes don’t show a positive result if you don't have a high level of HCG present. It will eventually show a positive result if you are pregnant, but it could be weeks before your HCG levels rise enough.
Q. I got pregnant immediately with our first child. My second child took a long time. I am 38 and do not want to take long for number three. I have begun taking an all natural fertility enhancer called Fertility Blend for Women. Do you have any opinion on the success I can hope to have? Are these types of "vitamins" worth investing in, or is it just a gimmick that I am wasting my money on?
A. From what I have heard and read about Fertility Blend for Women, I believe that you are better off just following a nutritionally balanced diet to promote pregnancy. The text in the advertising and information of the supposed fertility supplement only states that it may provide an attractive alternative or complement to conventional fertility therapy. In other words, your grandmother's spinach casserole may help get you pregnant, too.